Fair and Affordable Care Policy
Contents
1. Who this policy applies to
1.1 This policy applies to all individuals who have eligible needs and are entitled to receive adult social care support funded by Devon County Council.
1.2 This policy will apply in all circumstances where we are considering what support is needed to meet an individual’s eligible needs.
1.3 This policy will apply to both new assessments of need and reviews of need. (Where support is already in place – including situations where support is currently delivered via Direct Payments).
1.4 This policy will need to be considered when individuals are moving from Children’s to Adult Services.
1.5 This policy does not apply to individuals who are eligible for or receiving NHS Continuing Healthcare.
2. Why we have this policy
2.1 This policy describes how we will meet our duties in care planning and personal budget setting as described in the Care Act.
3. What this policy will achieve
3.1 This policy explains the way in which personal budgets are established when there may be different options for meeting a person’s eligible needs.
4. The Policy
4.1 We have a duty to assess and then ensure all eligible needs arising from that assessment are met. The identification of eligible need will be based upon the National Eligibility Criteria of the Care Act 2014. When conducting assessments and ensuring that eligible needs are met, we are under a general duty to promote the well-being of each individual.
4.2 Once we have identified that a person has a need for care and support, we must have regard to the following matters:
- (a) the importance of beginning with the assumption that the individual is best placed to judge the individual’s well-being;
- (b) the individual’s views, wishes, feelings and beliefs;
- (c) the importance of preventing or delaying the development of needs for care and support or needs for support and the importance of reducing needs of either kind that already exist;
- (d) the need to ensure that decisions about the individual are made having regard to all the individual’s circumstances (and are not based only on the individual’s age or appearance or any condition of the individual’s or aspect of the individual’s behaviour which might lead others to make unjustified assumptions about the individual’s well-being);
- (e) the importance of the individual participating as fully as possible in decisions relating to the exercise of the function concerned and being provided with the information and support necessary to enable the individual to participate;
- (f) the importance of achieving a balance between the individual’s well-being and that of any friends or relatives who are involved in caring for the individual;
- (g) the need to protect people from abuse and neglect;
- (h) the need to ensure that any restriction on the individual’s rights or freedom of action that is involved in the exercise of the function is kept to the minimum necessary for achieving the purpose for which the function is being exercised;
- (i) the importance of supporting people to live as independently as possible; and
- (j) each individual’s right to respect for his or her private and family life.
We also bear in mind Care and Support Statutory Guidance. This guidance confirms that there are often different ways of meeting an individual’s eligible needs. It also confirms that a local authority must ensure that there is sufficient funding available to meet the needs of the entire local population. Therefore, the guidance states that, while always having regard to the considerations identified in this policy, local authorities may (on a case-by-case basis) consider the total costs of different potential options for meeting needs, and choose the option which delivers the best value.
Promoting independence
4.3 The Care Act states that we need to consider promoting independence and reducing the needs a person has at every opportunity. The Act emphasises the importance of supporting people to live as independently as possible, and preventing or delaying the development of needs for care and support and the importance of reducing needs that already exist.
4.4 At every interaction with a person, a local authority should consider whether or how the person’s needs could be reduced or other needs could be delayed from arising.
4.5 Devon County Councils Promoting Independence Policy should always be applied and the potential for the following support should always be considered as ways of promoting independence:
- Providing information on healthy life choices
- Providing information on community resources
- Identifying personal strengths and supportive relationships.
4.6 Your care plan will wherever possible aim to reduce needs that already exist and to prevent or delay the developments of additional needs for care and support.
4.7 We will consider your home environment and whether changes could maximise your independence, for example a piece of equipment or adaptation to your home may meet your need.
4.8 We will arrange care in a manner that is sufficient to meet eligible needs and takes into account the choice and preferences of individuals. We will generally look to meet eligible needs by choosing the option for meeting needs which, based on the specific circumstances of each individual, represents the best value. When doing so, we will have regard to the matters listed above; and in particular to an individual’s wishes and preferences for their own care.
4.9 Occasionally the gross cost of your preferred support plan may be unable to be met in a way that represents best value to Devon County Council. While we will take into account the matters listed above, we expect that in the majority of these cases we will then treat the cost of the best value support option as a guideline cost level and fund care up to that level.
4.10 We have a top up policy that sets out the national rules for arranging an additional payment. These payments can be made either by yourself (in certain circumstances) or by a third party. This means you can receive your preferred care package if it is more expensive than your Personal Budget, which will be the best value option.
4.11 Top up rules are different depending on the accommodation setting that your care is delivered. Legislation prevents us from arranging top-ups for care and support being delivered in the community or in a person’s own home. You may wish to receive care in the community or in your own home that is more expensive than your Personal Budget. In this case you will need to enter into a private agreement with a care provider for any additional costs.
4.12 We are able to arrange for you to make a top up payment in residential and nursing care, shared lives schemes and supported living.
4.13 A financial assessment will determine how much you can afford to contribute towards your care. If you are making an additional top up payment to receive your preferred care, then when we assess how much money you have we include the amount of your additional payment.
4.14 We will identify the best value support plan that can be delivered to meet your eligible needs. This could include where a residential care service can meet your needs at a lower cost than the cost of care and support that would enable you to remain in your own home.
4.15 Each person’s circumstances will be considered individually, taking into account the matters listed above, and without reliance upon any form of blanket policy. In applying this policy, we will act reasonably and proportionately in ensuring that any care arranged will meet your eligible needs.
4.16 There may be circumstances that mean DCC would be prepared to exercise its discretion to fund care at a higher level of cost than the best value option for meeting needs.
4.17 We wish to make it clear that this policy will be invoked particularly where an option is available that represents better value to DCC than providing you with the necessary level of care in your own home.
Policy details
| Version | 6.0 |
| Strategic owner | Solveig Wright, Deputy Director of Integrated Adult Social Care (Commissioning) |
| Business owner | Keri Storey, Deputy Director of Integrated Adult Social Care (Operations) |
| Author | James Martin, Policy Manager |
| Date of approval and commencement | July 2015 |
| Last review date | April 2024 |
| Last reviewer | James Martin, Policy Manager |
| Next review date | Q1, 2026/27 |
| Changes at last review | Minor amendments and additions. |
| Supporting Documents | The Care Act 2014 and associated guidance and regulation Adult Social Care: Choice Framework Personal budgets policy Direct payments policy Promoting Independence Policy Choice in Care Policy Link to Officer Decision updating policy V6.0 |